Entisar Al-Zaman, Aysha S. ALZaman and Yahya AlZaman
Background: Malignancies have been often reported among patients with Sickle Cell Disease (SCD), with breast cancer being the most common cancer among females. However, the data available thus far in the literature on the safety of oncological treatments in patients with Sickle Cell Disease (SCD) especially that they are more prone to develop serious and even life-threatening treatment-related complications, is very limited.
Case report: Here, we report a case of a 48-year-woman with SCD who presented with metastatic Human Epidermal Growth Factor Receptor 2 (HER2) positive breast cancer and was treated accordingly with 3 weekly pertuzumab, trastuzumab anti-HER2 monoclonal antibodies and weekly paclitaxel 80 mg/m2 days one, eight, and 15 as per the standard regimen for metastatic breast cancer.
Unfortunately, the patient developed severe acute chest syndrome during the second cycle following the trastuzumab infusion requiring ICU admission; therefore, the anti-HER2 monoclonal antibody treatment was permanently discontinued. However, the patient successfully completed her paclitaxel chemotherapy cycles as planned. Furthermore, unlike trastuzumab, the patient tolerated lapatinib a tyrosine kinase inhibitor against the cytoplasmic domain of HER2 without any serious complications.
Conclusion: Anti-HER 2 monoclonal antibodies namely Trastuzumab and pertuzumab can precipitate acute chest syndrome in SCD patients with breast cancer.